1.Assessing quality of life among patients with pulmonary embolism
Javzan-Orlom D ; Munkh-Erdene D ; Zolzaya B ; Solongo B ; Chuluunbileg B ; Altankhuyag N ; Badamsed Ts ; Tumur-Ochir Ts
Mongolian Journal of Health Sciences 2025;86(2):154-159
Background:
The assessment of patients’ quality of life has emerged as a critical metric in evaluating healthcare services.
Internationally, numerous studies have been conducted to assess the QoL of individuals diagnosed with pulmonary
embolism through the development of standardized questionnaires and their association with various clinical parameters.
Aim:
To adapt a standardized questionnaire for assessing the quality of life following a pulmonary embolism and to evaluate
the quality of life of affected patients.
Materials and Methods:
A total of 33 patients diagnosed with pulmonary embolism and hospitalized in the Department
of Pulmonology at the Third State Central Hospital in Mongolia between August 2022 and December 2023 were included
in the study. An observational cross-sectional study design was used. Inclusion criteria encompassed all patients diagnosed
with PE during the study period, while exclusion criteria included individuals with severe comorbidities, those aged
over 85 years, and those who declined participation. QoL was assessed using the Pulmonary Embolism Quality of Life
(PEmb-QoL) questionnaire, which consists of 39 questions categorized into six domains. Higher scores indicate poorer
QoL. Data analysis was performed using SPSS version 16.
Results:
The average age of the participants was 61±15 years, and 18 (54.5%) were female. The median duration of anticoagulant
therapy was 170 days (range: 27–2555 days), and the average monthly expenditure on medication was 80,000
MNT (range: 63,000–400,000 MNT). The overall mean QoL score was 69.7±23.2. The median scores for the six domains
were as follows: frequency of complaints 1.6 (IQR 1.5-1.9; max 5 score), activities of daily living limitations 1.5 (1.3–1.8;
max 3 score), work-related problems 1.7 (1.5–2.0; max 2 score), social limitations 2.0 (2.0–3.0; max 5 score), intensity
of complaints 3.0 (3.0–4.0; max 6 score), emotional complaints 2.0 (1.5–2.4; max 6 score). The internal consistency reliability
of the questionnaire was assessed, with the symptom frequency category scoring well (α=0.74), while the other
categories had excellent reliability (α>0.85). A weak positive correlation was observed between overall QoL scores and
age, while a weak negative correlation was identified with body mass index (r=0.14 & r= -0.13, P>0.05).
Conclusion
The study findings indicate a low QoL among PE patients, emphasizing the necessity for enhancements in
post-diagnosis medical care and long-term management strategies to improve patient outcomes.
2.Risk Factors and Clinical Characteristics of Pulmonary Embolism Among Mongolian Patients
Javzan-Orlom D ; ; Chuluunbileg B ; Gantogtokh D ; Enkhtuguldur M ; Munkh-Erdene D ; Zolzaya B ; Enkh-Amgalan Ts ; Altankhuyag N ; Amgalandari B ; Badamsed Ts ; Tumur-Ochir Ts ; Solongo B
Mongolian Journal of Health Sciences 2025;90(6):55-62
Background:
The annual incidence of pulmonary thromboembolism is reported to be 39–115 cases per 100,000 population,
with rates of 60–120/100,000 in Western countries and 10–20/100,000 in Asian countries. In Mongolia, few studies
revealed the prevalence of risk factors and clinical manifestations of acute pulmonary embolism. Over the past 30 years,
the incidence of risk factors for non-communicable diseases, which are mainly triggered by lifestyle and social parameters,
has rose. Moreover, environmental conditions such as cold climate, hypoxia, and blood hyperviscosit may contribute
to higher incidences of acute pulmonary embolism in high-altitude regions. This condition is potentially fatal and can
become impair quality of life.
Aim:
We aimed to compare risk factors and clinical characteristics based on age and sex, and to evaluate laboratory findings
and diagnostic tests among Mongolian patients diagnosed with acute pulmonary embolism.
Materials and Methods:
This retrospective research included total 232 patients meeting inclusion criteria. The information
was collected from patient histories, including general demographics, risk factors, comorbidities, symptoms, and
physical examination findings. Laboratory analyses included complete blood count, coagulation profile, and immunological
markers (D-dimer, NT-proBNP, troponin, protein C, homocysteine, and C-reactive protein), as well as selected
imaging parameters. We used Wells and Geneva scoring systems to assess probability of acute pulmonary embolism and
Pulmonary Embolism Severity Index to determine disease severity. Differences by age and sex were analyzed using independent
t-tests for continuous variables and chi-square tests for categorical variables.
Results:
Among participants with acute pulmonary embolism, the prevalence of tobacco and alcohol use was significantly
higher among males (p<0.001). Among comorbidities, arterial hypertension and other pulmonary diseases were more
common in males, whereas cardiac diseases were more frequent in females (p=0.028). Participants aged 65 years and
older showed higher rates of comorbid conditions and regular medication use (p<0.001). The most common symptoms
were dyspnea (90.9%), chest pain (74.2%), cough (70.5%), leg pain (38.9%), hemoptysis (20.7%), and cyanosis (9.3%).
According to sPESI scoring, 69.8% (n=162) were at high risk of death within 30 days, with no significant difference by
sex. However, mortality risk within 30 days was significantly higher in participants aged 65 years and above (p<0.001).
As increasing age, the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were elevated, indicating an acute
inflammatory response (p=0.001). Contrast-enhanced CT scans revealed that 95 participants (44.2%) had main pulmonary
artery involvement, with no significant sex difference, though involvement of the main pulmonary artery was more
frequent in those aged 65 and older.
Conclusion
Dyspnea, chest pain, and cough were the most common symptoms among patients diagnosed with acute
pulmonary embolism. The 30-day mortality risk associated with it was higher among males and increased with advancing
age.
3.The clinical sign of children’s kidney and urinary tract petrification diseases and the result of ESWL
Baatartsogt S ; Amarjargal O ; Khurelbaatar U ; Oyunbileg U ; Gan-Erdene N ; Zolzaya G ; Enkhtur Sh ; Agiimaa D
Mongolian Journal of Obstetrics, Gynaecology and Pediatrics 2023;33(1):2401-2408
The clinical sign of children’s kidney and urinary tract petrification diseases and the result of eswl
Background: A substance exchange disorder where stones form in the kidney or urinary tract with a tendency toward inheritance is called urinary tract petrification disease. In many countries throughout the world, the incidence of urinary tract petrification disease is one to fifteen percent. Urinary tract permeability disease affects 7% of people under the age of 17. Due to the unique nature of the habitat, the incidence of urinary tract petrification disease is higher in India, Thailand, Scandinavian countries, and the Caucasian, Ural, Siberia, and Equator areas. However, the incidence of urinary tract petrification disease spread is two to three percent for children, but the reoccurance risk is 6.5–54 percent. In our country’s case, J. Horloo’s 1993 research indicates that 4.1 to 4.7 percent of kidney and urinary tract patients have urinary tract disease. During urinary tract disease, the common symptoms are abdominal pain, macro- and microhematuria, and kidney and renal bacterial infection. But in younger children, those symptoms are quite grim. In the last 15 years, mongolian’s urine’s oxalate stone’s volume increased by 5 times and mixed stones decreased by 2.5 times. The research of G. Erdenetsetseg’s 1990–1998 study on 305 children and the 2001–2003 study on 161 children indicate that the incidence of urinary tract disease is high between ages 1-3, and 65 percent of the stones consist of calcium oxalate. In 1980, German scientists invented the stone crushing technology using electrohydraulic shockwaves, which turned out to be a beneficial treatment for kidney surgery practice. The National Hospital for Maternal and Child Health's kidney surgery team had 17 surgeries in 2015, 19 surgeries in 2016, 24 surgeries in 2017, and 28 surgeries in 2018, and all of those surgeries were done and treated open. In the last 10 years of our country, children’s urinary tract petrification disease has gradually increased, but research on those diseases risks and factors is lacking. Also, the stone crushing method is necessary for our country’s children's treatment. That’s why we decided to do research on the risk factors of urinary tract disease and its relation to the stone crushing method.
Aim: Describe the features of children’s kidney and urinary tract petrification disease and study the stone crushing method’s results.
Materials and methods: The study was done between December of 2019 and April of 2022, with the assistance of NCMCH's children's kidney surgery team. Within the parameter of the first objective, within the group of cases of kidney and urinary tract disease, there were 13 children under the age of 17. The research study was conducted cross sectional. The research results were processed by the SPSS 25 program. On the seventh meeting of the health ministry, we got the acceptance of a research patent with the assistance of EHEMUT.
Results: The research group consisted of 13 children ages 0–17. The average age of participants was 10.6+-4.2.74. 4 percent of it consisted of men. The research of symptoms showed that back pain n = 13 (100), right side abdominal pain n = 13 (100), disurie n = 3 (23.1), mouth drying n = 2 (15.4), nausea n = 3 (23.1), urine with blood n = 10 (76.9), urine with smell n = 9 (69.2). The position of the stone consisted of 8 (61.5) in the kidney cup, 8 in the kidney cradle. Showing it in which kidney showed that 8 (61.5) were in the right kidney, 3 (23.1) in the left kidney, and 2 (15.4) in both kidneys. The density of the stones was n = 265.8+ 41.9 on average. Kidney stone coming out time was measured by Caplan-Myer’s survivability scale. The stones on the right side of the kidney came out within 14 days on average, while the left and both-sided kidney stones came out within 30 days.
Conclusions:
1. Showing the number of stones and locations indicates that 8 (61.5) were in the right kidney, 3 (23.1) in the left kidney, and 2 (15.4) in both kidneys.
2. The results of Caplan-Meyer's scale indicate that kidney stones within the right kidney came out within 14 days, and left- or both-sided stones came out within 30 days.
4.The effects of Particulate matter (PМ2.5) pollutants on cancer cells in in vitro model
Baljinnyam T ; Bilguun E ; Batchimeg B ; Zolzaya D ; Lkhaasuren N ; Oyungerel G ; Munkhtsetseg B ; Khaliun M ; Khulan U ; Batkhishig M ; Uranbileg U ; Sonomdagva Ch ; Bilegtsaikhan Ts ; Munkhbayar S ; Munkhtuvshin N ; Erkhembulgan P
Mongolian Medical Sciences 2021;197(3):17-25
Introduction:
Air pollution has become one of the major problems in socio-economic and health
issues in Mongolia. Among the various hazards of particulate matter (PM) pollutants, microorganisms
in PM2.5 and PM10 are thought to be responsible for various allergies and for the spread of respiratory
diseases. Recent studies have shown that PM2.5 particles can cause chronic heart failure, heart
arrhythmias, and strokes, as well as lung damage, cirrhosis, inflammation, cancer, cardiovascular
disease, and metabolic disorders. Furthermore, some studies have concluded that PM2.5 particles
in the environment are a risk factor for gastrointestinal, liver, colon, and lung cancer as well as it
affects the growth and metastasis of various cancer cells caused by other factors. In our country, the
health effects of air pollution and the relationship between the pathogenesis of cancer research are
scarce. Therefore, the study of the effects of PM2.5 particles on cancer cell proliferation, migration
(metastasis) can provide a significant role for cancer treatment, diagnosis, and prevention.
Purpose:
Determining the effects of PM2.5 particles on cancer cell proliferation, migration (metastasis)
in in-vitro
Material and Methods:
A human liver cancer cell line (HepG2), human gastric cancer cell line (AGS)
were obtained from the central scientific research laboratory in the Institute of medical sciences.
HepG2, AGS cells were seeded at a concentration of 1*105 cells/mL in a culture flask and cultured
in RPMI-1640 medium supplemented with 10% FBS, 1% antibiotic mix (penicillin, streptomycin) in a
humidified atmosphere of 5% CO2 at 37 °C. The cytotoxic effect of PM 2.5 in AGS, HepG2 cells were
evaluated by MTT, CCK8 assays. AGS, HepG2 cells were incubated in 96 well plates for 24h then
treated with different concentrations (0, 5, 10, 25, 50 and 100 μg ) of Bayankhoshuu, Buhiin urguu,
and Zaisan samples for 24h, respectively.
Results:
Concentrations of 10, 25, and 50 μg/ml of samples collected from the Bukhiin urguu and
Zaisan in March increased HepG2 cell growth, while doses of 25, 50 μg/ml of samples collected from
Bayankhoshuu in March and December increased HepG2 cell growth. Therefore, concentrations of
25 and 50 μg/ml of samples collected from Bayankhoshuu in March increased AGS cell growth, while concentrations of 25, 100 and μg/ml of samples collected in December increased AGS cell growth.
However, no cytotoxic effect was observed in the sample collected from Zaisan in March, whereas
the PM2.5 sample enhanced AGS cell growth in dose dependent manner in December.(p <0.05)
Conclusion
High levels of heavy metals were detected in samples collected in December from
Bayankhoshuu, Bukhiin urguu and Zaisan of Ulaanbaatar. Concentration of 25 μg/ml of samples
collected from the Bukhiin urguu and Zaisan in March increased HepG2 cell growth. Concentrations
of 25 μg/ml of PM2.5 collected from three regions around Ulaanbaatar increased HepG2 and AGS
cell migration.
5.Involvement of Vitamin D in Immune system
Baljinnyam T ; Batchimeg B ; Zolzaya D ; Ganchimeg D ; Lkhaasuren N ; Oyungerel G ; Munkhtsetseg B ; Khaliun M ; Khulan U ; Bilguun E ; Batkhishig M ; Tulgaa L ; Bilegtsaikhan Ts ; Munkhbayar S ; Munkhtuvshin N ; Munkhbat B
Mongolian Medical Sciences 2020;192(2):51-59
Research of function of vitamin D on immune system has been studying since the study revealed
that vitamin D receptor is expressed on the surface of the immune cells. 1,2-dihydroxyvitamin
D3 [1,25(OH)2D], physiologically active form, can be generated through hydroxylation of
25-hydroxyvitamin D3 [25(OH)D], inactive form of vitamin D, in a liver, connecting with specific VDR
make biological action. Vitamin D make different biological actions depends on connecting with
different immunological cells. Some studies indicated that Vitamin D plays pivotal role in antibacterial
innate immune responses through regulating reaction of the main cells as macrophages and dendritic
cells. Moreover, calcitriol, the active form of vitamin D, is connected with VDRE, modulates the innate
immune response through directly inducing expression of catelicithin and β-defensin as antimicrobial
peptides, reducing secretion of IL-1b, IL-6, TNF-a, RANKL, COX-2 as proinflammatory cytokines and
increasing production of IL-10, an anti-inflammatory cytokine. Vitamin D plays in proliferation and
differentiation of T and B cells and regulates the activities of over 500 genes. Vitamin D differently
impacts on per se stages of T cells’ proliferation. Vitamin D indirectly mitigates the differentiation from
immature B cells to plasma B cells while it directly impacts on regulation of overloaded production of
antibodies in plasma B cells. In conclusion, vitamin D modulates the innate- and adaptive immune
response through regulation on activation of APCells, proliferation and differentiation of immune cells,
secretion of some antibacterial peptides.
6.The prevalence and some risk factors of primary headache disorders among the school-aged children in Ulaanbaatar, Mongolia
Selenge E ; Byambasuren Ts ; Zolzaya N ; Otgonbayar L
Mongolian Medical Sciences 2018;185(3):49-53
Background:
The primary headache disorders are one of the most common complaints among children and adolescents. Migraine and tension-type headache (TTH) are the most frequently types of primary headache, with prevalence of approximately 9.1% for migraine and 10–24% for TTH among children.
The aim of this study was to determine the 1-year prevalence and some risk factors of primary headache disorders in school-aged children.
Material and Methods:
A cross-sectional, school-based survey consisting of semi-structured questionnaires was administered to randomly select aged 6-11 years using stratified multistage cluster sampling during the period from April to June 2018. The questionnaire of primary headache was based on International Classification of Headache Disorders-III criteria. Statistical analysis was performed by using the SPSS, version 21. Student’s T-test, chi-square test and analysis of variance were used for comparisons when appropriate. The level of statistical significance was set at p<0.05.
Results:
We surveyed totally 635 participants; the one-year prevalence of all types of headache was 54.6%. Prevalence of migraine and tension-type headache was 3.0% and 5.4%, respectively. Elucidated biometric and socio-demographic risk factors showed statistically significant difference in prevalence of migraine: type of household, life situation and residential quarter.
Conclusion
Our study found that frequency of prevalence of primary headaches among the school-aged children is relatively high and comparable with other countries.
7. EVALUATION OF THE SECONDARY SCHOOL EXTERNAL ENVIRONMENT SOLID WASTE MANAGEMENT IN ULAANBAATAR MONGOLIA
Zolzaya D ; Ser-Od Kh ; Batzorig B ; Nandin-Erdene O ; Oyunbileg N ; Davaalkham D
Innovation 2015;9(3):160-162
A school environment may cause positive effect upon health and healthy behavior, but also representmain factor for transfer of non-infectious diseases. Therefore, the issue of maintaining an appropriate environment in operations of training and educational institution would be considered as vital in every country of the world. In our country the solid waste hygienic conditions around children organizations represent one of actual problems. Through the research work was aimed to evaluate the state of solid waste at external environment of general educational institutions by the momentum model of analytical research and involving 103 state proprietary Educational Institutions of 9 districts. At developing estimation list of solid waste at external environment of schools were used current effective standards, resolutions and regulations. 88.3 percent of schools involved into research work had special solid waste-points and 11.7 percent had no special solid waste-points. 38.8 percent of solid waste-points were fenced from all sidesand 44.7 percent fenced from some sides and 16.5 percent had no fence in whole. The research of material from which was made a solid waste-keeping facility showed that 44.2 percent were made from metal, 2.3 percent from wood and 52.3 percent from brick. When we studied whether the solid waste-keeping facility is placed in distance of 25 meters from school according to standard,was determined that 71.8 percent were built according to the standard, 28.2 percent were allocated within 25 meters showing inconformity with the standard. During the research it has been detected that among schools 27.2 percent had too much solid waste-heap, 25.5 percent had placed no special recycle-bins on the school site and 13.6 percent conducted wrong activity by incinerating solid waste on the territory of school.2/3 or total 63 schools among Metropolitan state proprietary educational institutions has non- standard solid waste-keeping facility, 1/3 or 29 schools has located their solid waste-points in non- standard distance, there exists much solid waste-heap because of insufficient recycle-bins, absence of solid waste-points results in collection of solid waste in a special room inside of school and later its transportation with scavenger. Also, 13.6 percent or 14 schools are incinerating their solid waste within school site. This breeches effective hygienic norms and normative.
8.Study Of Managchenmo Liver Protective And Bile Secretion Effects On Ccl4- Induced Hepatotoxicity
Zolzaya N ; Alimaa T ; Chimedragchaa ; Ch ; Uranzaya D ; Bat-Erdene J
Journal of Oriental Medicine 2014;6(1):11-16
Managchenmo is a traditional Mongolian medicine functional liquor comprising
twelve crude drugs: Sus scrofa / cinis faecis /, Inula helenium L., Terminalia
chebula Retz., Melia toosendan Sieb, Gardenia jasminoides Ellis, Lagotis integrifolia
(Willd.)Schischk, Gentiana barbata Froel, Moschus moschiferus, Bezoar Bovis,
Calcio sinteris, Carthamus tinctorius L,and Saccharum officinarum. Nowadays the
Mongolian traditional herbs are more preferable than the chemical ones; for this
reason studies on their use history and new technologies are conducted. Thus we
study Managchinmo affects, herb for treatment of liver hot disorders, on trial rats
(Handa.S.S, Sharma.A .1990 ) with hepatotoxicity. The levels of serum alanine
aminotransferase (ALT), aspartate aminotransferase (AST) and
alkalinephosphatase (ALP) were determined through biochemical methods. The bile
duct was cannulated with a tube to collect bile for two hours and bile flow was
calculated by the weight of each specimen. Our results showed that Managchenmo
(150 mg/kg) significantly prevented CCl4-induced changes in bile flow and serum
levels of ALT, AST, and ALP. In conclusion, Managchenmo exerted a protective
effect on CCl4-induced hepatotoxicity in rats.
9.The current situation of the early detection and control of hypertension and its strategy
Nandintsetseg B ; Baigalmaa L ; Tsolmon U ; Serjee D ; Zolzaya B ; Angarmurun N
Mongolian Medical Sciences 2010;153(3):6-11
Background According to the report of World Congress of Cardiology in 2007, 1.5 billion people had hypertension and 45% of hypertensive people were unaware of their condition. In our country, some study had provided estimation of risk factors and prevalence of hypertension, but main characteristics presenting the early detection and control of hypertension have not been studied well and information does not exist.The quality of the control, registration and early detection of hypertension will be improved by studying this topic and complications and mortality due to the hypertension could be decreased.GoalThe aim of our study is to evaluate the current situation of the early detection, registration and control of hypertension, and to describe future strategyObjectives:1. To describe the hypertension awareness and risk factors associated with early detection of hypertension2. To evaluate the current situation of registration system of hypertension and to find out the strategies for renewing registration system3. To investigate the rates of the treatment and control of hypertension, and to survey factors associated with the control of hypertensionMaterials and MethodIt was population based, cross sectional, prospective study. Participants of the study were selected by randomized method.In the study, 1103 individuals, 133 physicians and 2 family hospitals located in Bayanzurkh, Songinokhairkhan districts, were surveyed. The study based on questionnaire and BP measurement which aimed to reveal:• Hypertension awareness (%)• Treatment (%)• Control (%)Software program name: Arterial hypertension registration and control Objectives of the program: to evaluate registration of arterial hypertension, to detect earlier, to determine control level of hypertension Users: family hospitals, family doctorsType of morbidity registration: population basedStatistical analysis was performed with SPSS-17 software program. Single- and multi-factorial analysis was explored by using simple and logistic regression and significance.ResultsIn the study, in total, 1103 people aged of ≥18 years living in Bayanzurkh and Songinokharkhan districts of Ulaanbaatar, have been involved. 37% of all participants were male and 63% were female and mean age of all participants was 40.6±16.1. According to our study, 305 individuals of 431 hypertensive participants (70.8%) were aware of their hypertension. This result was different in gender: 58.0% in male, 79.0% in female. Our research team created software program that can integrate all hypertension data to one database. We are planning to determine unawereness; aware and treated; treated and controlled; and uncontrolled levels by using this software and to introduce the program created by us to all primary level physicians in order to use routinely.Conclusions:1. Among hypertensive individuals, awareness of hypertension was 70.8%. Factors such as young age (<35), single people and not measuring BP for the last one year influence negatively on early detection of hypertension (p<0.05).2. Current method of hypertension registration is not proper at the time. Therefore, we concluded that renewing of the arterial hypertension registration database and conversion it into electronic type is convenient to control arterial hypertension and to provide integration.3. Treatment level of arterial hypertension was 39.9%, controlled arterial hypertension among all hypertensive population - 10.2% and among treated population – 25.2%.

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